Individual provider Active NPI

George Gary Walker, PH.D.

  • Psychologist
  • Lubbock, TX
National Provider Identifier
1154465409
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
24803 Issued in TX
Practice address
5120 29TH Dr Ste D
Lubbock, TX 79407-2612
Phone
(806) 798-8855
Fax
(806) 792-5715
NPI assigned
Feb 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 24803 TX
Psychologist 103T00000X 24803 TX Primary

Addresses

Primary practice location

5120 29TH Dr Ste D
Lubbock, TX 79407-2612

Mailing address

5203 28TH St
Lubbock, TX 79407-3507
Phone (806) 798-8855

Other identifiers 1

IdentifierTypeStateIssuer
034653802MedicaidTX

Other names 1

  • Dr. G. Gary Walker Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101014000154 TX Practitioner - Clinical Psychologist 6709962640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5120 29TH Dr
Lubbock, TX 79407-2612
Phone (806) 798-8855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
24803TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
G. Gary Walker, PH.D., P.C. Psychologist CurrentSince Jan 2, 2002 Accepting new patients

Locations

5120 29th Dr
Ste D
Lubbock, TX 79407
Phone (806) 281-9999

8008 Slide Rd
Ste 24
Lubbock, TX 79424
Phone (806) 340-0446

5120 29th Dr
Lubbock, TX 79407
Phone (806) 798-8855

5120 29th Dr
Ste C
Lubbock, TX 79407
Phone (806) 771-5357

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1154465409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 28TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073507",
            "telephone_number": "806-798-8855",
            "fax_number": "806-798-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 29TH DR STE D",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072612",
            "telephone_number": "806-798-8855",
            "fax_number": "806-792-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "GEORGE GARY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-19",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "24803",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "24803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034653802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "G.",
            "last_name": "WALKER",
            "middle_name": "GARY",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.